In a wake up call to curb and end corruption in health sector, Health CS Aden Duale has put health practitioners and patients on high alert, warning them of severe consequences for defrauding the Social Health Authority (SHA) fund.
A total of 35 health facilities have closed in an ongoing crackdown targeting activities that have been draining the SHA’s resources.
The CS outlined six key areas where fraudsters will face the full force of the law
Outpatient claim scams: Facilities converting outpatient claims to inpatient claims will be closed down without hesitation.
Forced admissions: Health workers colluding with facilities to admit patients unnecessarily will face disciplinary action, with both parties held personally responsible for any resulting fraud.
Code sharing: Patients sharing codes with hospitals to claim more services than received will be prosecuted alongside the doctors and facilities involved.
Pre-authorization code abuse: Doctors sharing pre-authorization codes to defraud the SHA fund will face prosecution.
Ghost patient admissions: Facilities admitting non-existent patients beyond their capacity will be brought to book.
Double billing: Facilities charging both SHA and patients in cash will be reported through the call center 147, with patients encouraged to speak out against such malpractices.
Speaking in Kisumu the CS stated that those who have been found to have fraudulently earned from SHA have been reported and will be subject to DCI investigations before being prosecuted.
